NDIA Accountability Project

Submission to the Joint Standing Committee on the National Disability Insurance Scheme (NDIS) - Capability and Culture of the National Disability Insurance Agency (NDIA).

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Submission

Northern Territory Government

Submission

**to the Joint Standing Committee on the National Disability Insurance Scheme (NDIS) - Capability and Culture of the National Disability Insurance Agency (NDIA).

Introduction

The Northern Territory Government is committed to meeting our obligations under the United Nations convention on the Rights of Persons with Disabilities, Australia’s Disability Strategy, and the Closing the Gap National Agreement, to ensure people with disability have equitable access to services and opportunities to participate in community, no matter where they live.

The Northern Territory has a small, culturally diverse, dispersed population over a remote and very remote geography. Our unique demographic and distinct characteristics requires innovative and flexible place-based localised solutions, to unpack and resolve thin to non-existent markets, remoteness, cross cultural service provision and systemic change, with the understanding of what works in one remote Aboriginal community may not work in the neighbouring community. The Northern Territory requires a unique remote service delivery operating context for delivery of the National Disability Insurance Scheme (NDIS). The NDIS transition has been a journey and continues to require a rigorous, combined effort by the Northern Territory and Commonwealth Governments and Territorians with disability.

The Northern Territory completed the transition to the NDIS on 1 July 2019, with approximately 20,700 people identifying with disability (Australian Bureau of Statistics in 2018). As of 31 August 2022, the Northern Territory had 5,112 NDIS participants, 2,571 (50.3 percent) identified as Aboriginal and/or Torres Strait Islander (Aboriginal), with a further 328 (6.4 percent) identifying as Culturally and Linguistically Diverse (CALD). These figures indicate that only a quarter of Territorian’s with disability, have transitioned onto the NDIS.

To improve the uptake of the NDIS, the Northern Territory wants the National Disability Insurance Agency (NDIA) to focus on the following recommendations: - a simplified, face-to-face accessible process for NDIS eligibility, to increase the percentage of Territorians on an NDIS package; - culturally safe engagement by the NDIA through an increased number of local Aboriginal people employed in the Northern Territory NDIA offices; and - place-based, tailored solutions for the operating model in remote communities that are informed by local effective frameworks, services and personnel through a review of current NDIS policy on the employment of Aboriginal and CALD people to deliver disability support services.

The Northern Territory Government is committed to ensuring Territorians have access to high quality services, and we will continue working with the NDIA to develop the disability market, particularly in remote and very remote Aboriginal communities, in a way that maximises Aboriginal economic participation and community-based decision-making.

Further detail is provided within this submission, as the Northern Territory continues to focus on creating a society that removes barriers for people with disability to live full and prosperous lives. The Northern Territory’s submission was developed with feedback received during consultations with people with lived experience of disability from all across the Northern Territory, advocates, service providers, and peak bodies who contributed to the formation of the Northern Territory Disability Strategy 2022-2032.

Feedback on the impacts of NDIA capability and culture on the experiences of people with disability

and NDIS participants trying to access information, support and services from the Agency is as follows:

Meeting access requirements

The application process to access an NDIS package is confusing and difficult and there are limited services that can assist individuals with the process. More support is needed to complete documentation and more information needs to be available in Aboriginal languages.

Between April and June 2022, 272 access decisions were made in the Northern Territory, and 216 met access (NDIS Northern Territory Quarterly Performance Dashboard, 30 June 2022). This leaves 56 people in this quarter who made an access request and have not met access. There is currently no data on the number of people with disability in the NT who require supports from the NDIS but have not had the support required to lodge a successful access request.

Barriers to NDIS access for participants in the Territory are:

  • lack of information;
  • difficulties in evidence gathering; and
  • lack of support to complete an access request.

Recommendation 1:

A simplified, face-to-face accessible process for NDIS eligibility, to increase the number of eligible Territorians receiving support from the NDIS.

Culturally competent

“When assessors come out to community from NDIA it is a secret process and not explained or sighted by participants in NDIS. NDIS participants are not signing documents regarding their planning or having it explained to them with staff, family and explained in language.” – Participant from Kalkarindji.

The success of the NDIS in the Northern Territory depends on the NDIA working together with Territorians, ocross the depth and breadth of the Northern Territory. Working together with communities, identifying the key features and strengths, supporting local planning and co-designing innovative solutions to support all people with disability.

The employment of Aboriginal people needs to be a priority. This can be achieved through both an increase in the number of Aboriginal people employed by the NDIA, and a community-based disability workforce which will require changes to the operational guidelines on employing family members. For people with disabilities living on remote Aboriginal communities, having access to culturally appropriate, trained, locally- based staff would greatly improve outcomes for NDIS participants and utilisation percentages of existing NDIS packages, and also improve engagement with the NDIA.

There are 2,571 Aboriginal and Torres Strait Islander participants, which is 50.3 per cent of the total number of NDIS participants in the Northern Territory. This high proportion means there is a demand for culturally appropriate services to people able to access the supports to which they are entitled. Quality services that build strong, culturally appropriate relationships are more important than the quantity of services.

Aboriginal people with disability living on community have clearly stated that they want to continue living on their traditional country with family and culture. This should be expressly acknowledged as a right and choice.

Continued engagement is required to understand that a person with disability may require specialist disability support and services not available within their community. Extensive work is required with the

Remote Service Delivery

Due to limited service delivery (thin to non-existent markets), transition to the NDIS has been particularly challenging in parts of the Northern Territory. Although there is some service coverage for Darwin urban areas, there is a substantial decrease in service availability outside of this region. People with disabilities are often forced to leave their homes to access supports, disconnecting them from their community, family and culture. The ongoing issues around the development of a disability services market continues to pose a significant risk to the effectiveness of the NDIS in the Northern Territory.

A large part of the Northern Territory is considered remote or very remote. Of the total 5,112 NDIS participants in the Northern Territory, 1,903 live outside of the Darwin Urban region. The market challenges include geographical isolation, higher operating costs, and workforce shortages. Subsequently, a lack of adequate services has resulted in low plan utilisation, with NDIS participants unable to use their plans to access the supports they need. Flexible, place-based models and local-solutions are required as the one size fits all implementation of the NDIS has failed to address the experiences of Aboriginal people in remote and very remote communities. Lack of flexibility has led to wasted resources, poor service delivery and costly but unsatisfactory outcomes for people with disabilities living on community. NDIS service providers in the Northern Territory are not able to plan on services in remote areas due to the individualised nature of funding. People would like to see more investment in local providers and jobs, and less fly in /fly out workers.

Early Childhood Approach

There are 104 children across the whole Northern Territory accessing early connections (NDIS Northern Territory Quarterly Performance Dashboard, 30 June 2022). The NDIA is currently funding two Partners in the Community (PiTC) programs for the Northern Territory, they are Early Childhood Australia – Northern Territory Branch for Early Childhood Early Intervention (ECEI) services in Darwin, Palmerston and Litchfield and APM Darwin for Local Area Coordination services in Darwin, Palmerston, Litchfield and Batchelor. The Northern Territory has over 2,000 (NDIS) participants, living outside of the service areas for the PiTC program. It is critical for the NDIA to fund additional Partners in the Community (PiTC) programs to accommodate the immediate needs of Territorian’s with disability living outside of the Darwin region.

There are several key issues impacting the Northern Territory including: - the lack of an Early Childhood Early Intervention Partner in areas outside Darwin has children aging out of early childhood services, before having the opportunity to access the expertise in family- centred supports for the child; - the limited volume and capacity of private providers to service the number of children eligible for NDIS funded early childhood supports in Alice Springs, remote and very remote regions. There is an inadequate number of ECEI services provided outside of Darwin, resulting in children and families not having choice and control and reduced utilisation of their NDIS funded supports; and - up to 50 per cent of NDIS participants identify as Aboriginal and Torres Strait Islander. Parents, families and caregivers living in Alice Springs and remote and very remote locations need to feel safe and secure, by receiving place based services in line with delivering participant outcomes.

Recommendation 8: Targeted solution focussed discussions are required between the NDIA and the Northern Territory to put services in place to accommodate the immediate needs of people with disability living outside of the Darwin region in the Northern Territory.

Recommendation 9: More investment is needed in holistic supports with a focus on early therapeutic intervention / prevention in remote areas.

Coordinated Service Delivery “They have their own rules and regulations and confuse issues, some of the corporate NDS people have no understanding of special needs and all the extra components that a parent has to take on. Lack of case management services is an issue, we need a case manager that acts as an advocate and holds service providers to account. A lot of the NDIS corporate people are not local and don’t understand the lack of services in Darwin. There is no easy way to share information and goals across all stakeholders so that we can all work together.” – Parent in Darwin.

Effective coordination for service delivery across governments (Local, Territory and Commonwealth) and Aboriginal Community Controlled Organisations can enhance the ability and quality of the NDIA and disability support. The existing NDIA approach to service delivery is not effective in the Northern Territory. The NDIA must work together with people with disability, to support each other to design and deliver policies and procedures specifically for the Northern Territory through: - community readiness – concerns identified, collated and prioritised by people with disability, community members and existing service providers located in the community

  • strategic acumen - policies and strategic plans must focus on flexibility, appropriate cultural practices, local solutions for local issues; and
  • employment of local Aboriginal people (where required) to deliver the coordinated service delivery model. Local, community based people have a distinct advantage with local knowledge, trusted relationships and pre-existing contacts over a workforce providing an intermittent service delivery model, from afar.

Recommendation 10: The coordinated service delivery model needs to be formalised, structured, fully integrated and specifically focussed on the individual needs of each community. A successful and effective coordinated service delivery model will include: - identification and addressing the needs of the community; - cultural competencies; - co-designed strength based approach; and - investment of resources and time.

Recommendation 11: A senior role within the NDIA responsible for all Northern Territory matters, including provider engagement and participant support would enhance, for remote areas in particular, the cultural appropriateness, relevance of services and the ability to meet the needs of people with disabilities and their carers.

Interface between criminal justice system and the NDIS Inadequate disability support is linked to cycles of offending and re-incarceration for people with disability. The identification of people with disability and providing the services and support required by people with disability in custodial settings is imperative to breaking this cycle. Once people with disability leave prison, they continue to face significant barriers in accessing NDIS services, which has implications for their continuing involvement with the criminal justice system. Appropriate supports need to be established to ensure successful transition from prison/institutions to the community. Gaining access to appropriate disability services before release date is critical to prevent an ongoing cycle of involvement with the justice system.

Recommendation 12: NDIA funding for a specialised role to support transitions from prison/institutions would be of considerable benefit.